Summit
Critical Crazy
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http://www.emsscopeofpractice.org
The second revision for the new national scope is out.
My summary so far:
EMR's (FR's) get OPA/NPA and autoinjectors for self/peer hazmat use (atropine, 2pam, etc) and upper airway suctioning (i think this is new for them)
EMT (B): get... OTC oral anaglesic
still get MAST/PASG and demand valve ventilators
nothing about allowing nonprescribed epipens
infact:
AEMT Advanced EMT (I's): get... nothing new?
Specifically says no ET and no NGT. (later in the document it specifically says ET is an AEMT skill, go figure)
and by specifically marking "ventilation of already intubated patient" and BGL as an AEMT skills, they technically rule out such a skills for EMR and EMT due to the "any skill specifically identified as an entry skill for a higher level" is not in an EMR or EMT scope.
Paramedic: didn't see anything new, just mentions no RSI for Ps
AEMT use of IO or pleural decomp is not in their scope because they are mentioned as a specifically paramedic skills
Advanced Practice Paramedic: This idea has been eliminated.
Further: Under the specialiation section, the document states
This scope doesn't like the idea of IV tech etc etc.
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I think State control of scopes is vital because what works in New Jersey (pop density 1,134/sqmi) probably won't be what's best for Wyoming (pop density 5/sqmi). (Cue lecture on the entire purpose behind local government and rules)
The current situation is a restrictive national scope and sometimes broader local scopes.
This doesn't allow for interstate compatibility. Joe Schmoe learns the NR minimums but if they go to a state that allows for epi use or LMAs, they may have to go through EMT training all over again because that state doesn't think enough of the national scope.
I agree with a National Scope to allow portability, but it seems to be that the National Scope should be broader and the state scopes restrictive to allow or this portability. That way a EMT has to be able to combitube for the NR, but may not be able to combitube locally. However, they will be good to go when they move the next state over that allows combitubes.
In summary, I think the national scope and training for the NR should be broad for while local scopes can be more restrictive as the environment calls for, this is the only way to ensure interstate compatibility of certifications.
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Raise your voices for the next revision.
The second revision for the new national scope is out.
My summary so far:
EMR's (FR's) get OPA/NPA and autoinjectors for self/peer hazmat use (atropine, 2pam, etc) and upper airway suctioning (i think this is new for them)
EMT (B): get... OTC oral anaglesic
still get MAST/PASG and demand valve ventilators
nothing about allowing nonprescribed epipens
infact:
So NO combitube or LMA in the national scope. Lame.The following are NOT skills of an EMT:
insertion of an airway adjunct intended to go deeper than the oropharynx
monitoring IV infusion
administration of prescription medications
AEMT Advanced EMT (I's): get... nothing new?
Specifically says no ET and no NGT. (later in the document it specifically says ET is an AEMT skill, go figure)
and by specifically marking "ventilation of already intubated patient" and BGL as an AEMT skills, they technically rule out such a skills for EMR and EMT due to the "any skill specifically identified as an entry skill for a higher level" is not in an EMR or EMT scope.
Paramedic: didn't see anything new, just mentions no RSI for Ps
AEMT use of IO or pleural decomp is not in their scope because they are mentioned as a specifically paramedic skills
Advanced Practice Paramedic: This idea has been eliminated.
Further: Under the specialiation section, the document states
Specialty certifications must not be used to change the scope of practice of an individual.
This scope doesn't like the idea of IV tech etc etc.
-
I think State control of scopes is vital because what works in New Jersey (pop density 1,134/sqmi) probably won't be what's best for Wyoming (pop density 5/sqmi). (Cue lecture on the entire purpose behind local government and rules)
The current situation is a restrictive national scope and sometimes broader local scopes.
This doesn't allow for interstate compatibility. Joe Schmoe learns the NR minimums but if they go to a state that allows for epi use or LMAs, they may have to go through EMT training all over again because that state doesn't think enough of the national scope.
I agree with a National Scope to allow portability, but it seems to be that the National Scope should be broader and the state scopes restrictive to allow or this portability. That way a EMT has to be able to combitube for the NR, but may not be able to combitube locally. However, they will be good to go when they move the next state over that allows combitubes.
In summary, I think the national scope and training for the NR should be broad for while local scopes can be more restrictive as the environment calls for, this is the only way to ensure interstate compatibility of certifications.
-
Raise your voices for the next revision.